5 - Obs - Hypertensive Disorders in Pregnancy - Pre-existing HTN in Pregnancy Flashcards Preview

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Flashcards in 5 - Obs - Hypertensive Disorders in Pregnancy - Pre-existing HTN in Pregnancy Deck (7):
1

BP already ? or exceeds ?/? before ? weeks
-present in ?% of pregs
-more common in ? and ? women, women with +ve ? or who dev HTN taking ?
-preg-induced HTN > underlying ? to HTN and may need trt in ??

treated
140/90
20
5
older
obese
FHx
COCP
predisposition
later life

2

Aetiology -
1’ or ? HTN is ? common cause. 2’ HTN commonly ass w ?, ? or renal disease eg ????, renal aa ? or chronic ? . Rare causes: phaeochromocytoma, Cushing’s, ? disease and ? of aorta.

idiopathic
most
obesity
DM
PCKD
stenosis
pyelonephritis
cardiac
coarctation

3

Clinical features - HTN ? in late preg. ? usually absent, although ? changes, ? bruits and ? delay should all be excluded in HTN
? with renal disease is normally present at ?

incr
Sx
fundal
renal
radiofemoral
proteinuria
booking

4

Complx - principal risks are ? HTN and ?, the risk for which is ? incr, other than these, perinatal ? is only marginally incr

worsening
preeclampsia
6x
mortality

5

Ix - To ID ? HTN:
-In ? cases, ? should be excluded w 2x 24h ?collections for ? acid (VMA). Worthwhile as ? mort of this is v ? .
- To look for ? disease: ?function assessed and renal ?
done.
- To ID pre-eclampsia: ? of any proteinuria at ? and a ?acid level allow for ? in later preg.

2'
severe
Pheochromocytoma (NE tumour, adrenal glands, secr adrenaline)
urine
vanillymandelic
maternal
high
coexistent
renal
USS
quantification
booking
uric
comparison

6

MGMT -
HTN: Ideally, ? changed pre preg, ? are teratogenic and affect fetal ? prod. ? normally used, w ? a 2nd line agent. Meds may not be req in ? trim due to ? fall in BP.

meds
ACEis
urine
labetalol
nifedipine
2nd
physiological

7

MGMT -
Risk of Pre-eclampsia: Preg trt as ? risk. ? w uterine aa ?
and additional ? visits is usual. Low-dose ? is advised. Pre-eclampsia suggested by ? HTN and confirmed by signif ? for first time after ?weeks.
Delivery: Usually undertaken by ? weeks, though benefits debated.

high
screening
doppler
antenatal
aspirin
worsening
proteinuria
20
40

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